MO-28112_47377_C_NFA_20210715_CNFA

July 15, 2021

Sam's Mart, Inc
7935 Council Place, #200
Matthews, NC 28105
Attention: Adnan Jazairi

Re: Conditional Notice of No Further Action
15A NCAC 2L .0407(d)
Risk-based Assessment and Corrective
Action for Petroleum Underground
Storage Tanks

Sams Mart 80
8325 Old Statesville Rd
Charlotte, NC
Incident Number: 47377

Mr. Jazairi:

The Limited Site Assessment Report received by the UST Section, Division of Waste Management,
Mooresville Regional Office on June 15, 2021 and the incident file has been reviewed. The review indicates
that groundwater contamination meets the cleanup requirements for an intermediate-risk site but exceeds
the groundwater quality standards established in Title 15A NCAC 2L .0202.

Be advised that as groundwater contamination exceeds the groundwater quality standards established in
Title 15A NCAC 2L .0202, groundwater within the area of contamination or within the area where
groundwater contamination is expected to migrate is not suitable for use as a water supply.

Pursuant to NCGS 143B-279.9 and 143B-279.11, you must file the approved Notice of Residual Petroleum
with the Register of Deeds in the county in which the release is located. The NORP filing is required prior
to conveyance of a contaminated property and/or prior to receiving a Notice of No Further Action. The
NORP must be prepared in accordance with instructions and format which can be found at:
http://deq.nc.gov/about/divisions/waste-management/waste-management-permit-guidance/underground-
storage-tanks-section/ust-guidance-documents.

The NORP must be sent to this office of the UST Section for approval and notarization. The approved and
notarized NORP will be sent back to you for filing with the Register of Deeds in Mecklenburg County.

As groundwater contamination exceeds the groundwater quality standards established in Title 15A NCAC
2L .0202, public notice in accordance with 15A NCAC 2L .0409(b) also is required. Thus, within 30 days
of receipt of this letter, a copy of this letter must be provided by certified mail, or by posting in a prominent
place (if certified mail is impractical) to the local health director, the chief administrative officer of each
political jurisdiction in which the contamination occurs, and all property owners and occupants within or
contiguous to the area containing contamination. Please include a cover letter that: adequately explains the
NFA, interested parties may examine the incident file by contacting this regional office, and comments on
the incident closure may be sent to the address listed below.

Within 60 days this office must be provided with proof of receipt or of refusal by the addressee(s) to accept
delivery of the copy of the letter, or with a description of the posting.

This conditional No Further Action determination will not become valid until the UST Section receives a
certified copy of the Notice of Residual Petroleum filed with the Register of Deeds, and until public notice
requirements are completed.

This No Further Action determination applies only to the subject UST incident; for any other NCDEQ
incidents at the subject site, the responsible party must continue to address contamination as required. If
you have any questions regarding this notice, please contact me at the address or telephone number listed
below.

Sincerely,

Daniel Bowser, PG
Hydrogeologist
Mooresville Regional Office
UST Section, Division of Waste Management, NCDEQ
[phone]

cc via email: Aaron Long, PE, ECEA
Shawna Caldwell, LUESA- Mecklenburg County Health Department